Resilience

The oxford dictionary definition of Resilience: "The capacity to recover quickly from difficulties; toughness"

A particularly topical subject at the moment is the third disqualification of Team GB's speed skater Elise Christie in Sochi for the Winter Olympics. Now this is someone who is going to have to demonstrate resilience to make her come back. It is a characteristic of huge importance to Sporting success as it is pretty much a given that any long term ambitious sporting goal will inevitably include failure. It is a necessary requirement for success.

Professor Sir Michael Rutter is Professor of Developmental Psychopathology at the Institute of Psychiatry, Kings College, London. He set up the Medical Research Council Child Psychiatry Research Unit in 1984 and the Social, Genetic and Developmental Psychiatry Research Centre 10 years later. He talks intelligently on the subject of resilience, proposing the foundations of coping are laid down in childhood.
This idea that stress is harmful or bad is not the full story. Stress and exposure to stress is very necessary for positive adaptation, both physically and mentally. This was one of the fundamental ideas written in the book: The stress of Life by Hans Selye (1956); that appropriate stress is good.
You don't develop good physical health by avoiding all contact with germs, you develop good health by being exposed and coping. The same thing applies to mental health, where stress is a necessary part of growing and evolving. This is one disadvantage for the "cushy" life. The more cushioned your life is, the more surrounded you are by "groupies" and people that will dote on you, so the more distressing any intrusion on that comfort will seem.

A distinct Lack of resilience and coping after discovering "Greens" in my diet 

Some people seem inherently better than others with coping with stresses of life and loss, whereas others do not fare so well and often turn to less healthy methods of coping, which can often include drug and alcohol abuse.

My point is, most people have a breaking point. I have seen professional athletes retire from sport, become ill or injured; some deal with that loss well and others not so well. There are numerous heartbreaking examples of alcoholism and drug abuse in many of the great sporting hero's.
http://drugabuse.com/30-famous-athletes-who-have-battled-drug-addiction-and-alcoholism/
There are also numerous examples of those that experience similar mental anguish that are not in the limelight. It made me really think about drugs and alcohol as a coping mechanism and in the general arena of Sport, where it seems the two unfortunately go hand in hand. This thought process tied in nicely with a talk by Professor David Nutt at The University of Westminster on Thursday 20th March. He is a  British psychiatrist and neuropsychopharmacologist who was famously sacked from the Advisory Council on the Misuse of drugs for downplaying the harmfulness of Class A drugs, saying Alcohol was more dangerous than Ecstasy and LSD. He has since set up the Independent Scientific Committee on Drugs (ISCD) and has written a book: Drugs - Without the Hot air: Minimising the harms of legal and illegal drugs.

Drugs -Without the Hot Air

When asked the question "why are you so interested in drugs"? he replied ""perhaps we need to rephrase the questions to....how can you not be interested in drugs?"
I think that sums it up pretty nicely. Drugs are interesting for so many reasons. Robust evidence based science on drugs also contributes to the fascinating question of how the brain works. This becomes hard to do when drugs are illegal. The documentary "The Ecstasy Trial", a live trial of MDMA (3,4-methylenedioxy-N-methylamphetamine) was funded by Channel 4 money. Without that, it is unlikely the scientific research that emerged from that would have happened.
David Nutt's quest is to inform the general public on the relative risk of drug taking and to make sure research continues into these drugs which may have beneficial effects for treating mental illness.

How can you quantify how harmful a drug is?

This to me is an interesting question. When the UK's Misuse of Drugs Act became law in 1971, drugs previously controlled under the Poisons Act were categorised into 3 classes; A, B and C. The intent of this system was to reflect the harm the substance would cause. It was also meant to be flexible so these substances could move up and down the tiers depending on what evidence emerged. The Advisory Council on the Misuse of Drugs (ACMD) was also created by the act to examine the science and produce government recommendations. It's not hard to believe that these recommendations don't get followed. Politics and the media have a wonderful way of distorting and cherry picking facts to enhance a story.

It is extremely difficult to measure harm, but Prof. Nutt has made a stab at it using a model based on multi criteria decision analysis of the below factors. A panel of experts subjectively "weighted" the importance of each of these criteria and the outcome was illustrated in figure 1. By his own admission it is not a full proof model, it is more an "interpretation" of science rather than "pure" science but it is certainly an improvement on the current classification system.

Different sorts of harm

Harm to users

• Drug specific mortality
• Drug related mortality
• Drug specific harm
• Drug related harm
• Dependence (Addiction)
• Drug specific impairment of mental functioning
• Drug related impairment of mental functioning
• Loss of Tangibles
• Loss of relationships. 

Harms to others

• Injury
• Crime
• Economic Cost
• Impact on family Life
• International damage
• Environmental damage
• Decline in reputation of the family

Figure 1: The 20 drugs considered in the ISCD's 2010 report, ranked by overall harm. 

What's the point?

There are several conclusions one could make from the above figure. The take home message to me is not the harmlessness of the drugs towards the right of the figure but quite how harmful alcohol is. I think one crosses over into dangerous territory if assuming drugs like LSD and Ecstasy are not harmful. Granted, LSD has a low addiction risk and has even been attributed to the creative success of many famous people, including Francis Crick (co-discoverer of DNA). One of my favourite quotes below is from Kary Mullis, the Nobel Prize winner who invented the polymerase Chain Reaction (PCR), a molecular Biology tool to amplify DNA.

"Would I have invented PCR if I hadn't taken LSD? I seriously doubt it....[having taken LSD] I could sit on a DNA molecule and watch the polymers go by. I learnt that partly on psychedelic drugs"

The problem is, a good experience is also to do with dose, the takers mental state and their environment. This seems to be a common theme with most drugs where you can limit damage by controlling dose and taking them sensibly. How that translates into "reality" I'm not so sure.
This new classification scheme is complex; like all things, it is rarely black and white but shades of grey. Natural, and consequently synthetic drugs have been around since the beginning of mankind and I can only predict they will be around until we cease, so learning to co-exist is necessary. Understanding what they can and cannot do. their absolute and relative risk is essential and how they can enhance our understanding of brain science is essential.
Nutt comes to it from a point of interest of finding and using drugs that can treat mental illness but  that is not the same as taking drugs recreationally. He continues the debate of the harmfulness or harmlessness of drugs. He suggests through evidence based science that some drugs if regulated and taken sensibly for certain groups are beneficial e.g LSD or Ecstasy for Post Traumatic Stress Disorder (PTSD). He may have a point. Surely regulated and well advised use of LSD is better than over consumption of alcohol as a short term pharmacological coping strategy? I don't advocate drug use and I think legalising them can come with all sorts of problems as people generally will not take them sensibly. Perhaps this is the reason why alcohol, which is readily available is so dangerous.

I brought up this topic because in an ideal world people would turn to holistic meditative strategies to deal with stress, but in reality it doesn't work like this and so to broach pharmacologic substances as a "tool" is important. But what comes with that is an essential requirement to know just how dangerous or not they are and to interpret data with care!!